There’s no question that hospitals, doctor’s offices, and long-term care facilities will always be mainstays in the health care industry. However, if current trends persist, home health services — already staples for many elderly patients and their families — will be increasingly in demand in the future. Like many in the home health industry, the faith-based home care provider HealthKeeperz, headquartered in Pembroke, North Carolina, is looking to the days ahead with a mixture of caution and optimism.
HealthKeeperz notes that while some changes in Medicare coverage slated for 2023 and telehealth technology advances offer exciting new possibilities for the growing home health care community and the population they serve, not all the news on the horizon is positive. Keeping abreast of home health care policy developments affords providers the opportunity to offer clients solid guidance and steer them toward the most viable solutions, while staying up to date on emerging applicable technology allows them not only to deliver the finest care, but to strengthen the caregiving community as a whole.
HealthKeeperz’s Advice: Let Experts Guide You Through Coming Changes
Traditionally, Medicare Advantage plans have offered benefits as determined by a set of “primarily health-related” factors. As of 2023, many of these plans will be broadening their definition of “primarily health-related” to include a wider scope of nonmedical and home-based service options.
“Prior to 2019, Medicare Advantage plans could provide additional benefits over the base Medicare benefits. These benefits had to be primarily health related and available uniformly,” the ATI Advisory, a Washington, D.C.-based health care research and advisory services firm explained in a recent report. “Expanded authorities now allow plans to offer a broader variety of meaningful benefits and allow for more targeting of benefits.”
Included in the Benefits
These benefits will include expanded in-home enrollee support services, support for caregivers of enrollees, adult day health services, home-based palliative care, and therapeutic massage, as well as some approved home modifications, transportation to nonmedical destinations, and provision for food/produce and meals (as outlined in the Special Supplemental Benefits for the Chronically Ill).
New, Broader Definition
Under this new, broader definition of “primarily health-related,” more services and benefits will be available through Medicare Advantage plans, but uniform availability is no longer mandatory. That means not every benefit offered will be available in every location nationwide, so you may or may not be eligible for certain care or services, depending on which plan you choose and where you live. (The Medicare case specialists at HealthKeeperz suggest consulting with an expert before signing up for any Medicare Advantage plan to ensure it targets your specific needs and those of your caregivers.)
HealthKeeperz Explains the Medicare Telehealth Conundrum
Additionally, some waiver-based Medicare benefits relating to telehealth previously approved during the pandemic will either change or discontinue in 2023. According to the September 2021 Medicare Telemedicine Snapshot, “Telehealth services have increased more than thirtyfold since the start of the [public health emergency], and have been utilized by more than half of the Medicare population. Telehealth and other digital health modalities continue to increase in importance for Medicare populations and corresponding health care providers.”
Study Results
Per a Nov. 21, 2022 report by the American Medical Association, of patients age 65 and over who were recently surveyed for a study published in the Journal of the American Geriatrics Society, the majority admitted to preferring in-person care, even though they told researchers “they were satisfied with the care they received via telehealth and they want it to continue to be an option.”
CMS
With waiver programs reaching their expiration date, the hands of the Centers for Medicare and Medicaid Services (CMS) are tied. Without legislative intervention, coverage for some crucial services will discontinue — but the fight isn’t over yet. “Telehealth is fundamental to care,” advised the AMA in a Sept. 14, 2022, op-ed. “Now the Senate must act like it and pass the Advancing Telehealth Beyond COVID-19 Act.”
On Nov. 1, 2022, CMS issued its final 2023 Medicare Physician Fee Schedule containing the new benefits guidelines. In a summary of the nearly 3,000-page document by the expert attorneys at Foley & Larder LLP, a global legal firm specializing in the energy, health care/life sciences, innovative technology, and manufacturing sectors, the most relevant changes were as follows: discontinuing reimbursement of telephone (audio-only) evaluation and management (E/M) services; discontinuing the use of virtual direct supervision; five new permanent telehealth codes for prolonged E/M services and chronic pain management; postponing the effective date of the telemental health six-month rule until 151 days after the public health emergency (PHE) ends; extending coverage of the temporary telehealth codes until 151 days after the PHE ends; and adding 54 codes to the Category 3 telehealth list and modifying their expiration to the later of the end of 2023, or 151 days after the PHE ends.
If you’re having trouble making sense of the legal and medical jargon, you’re not alone. Again, that’s why having a trusted Medicare case adviser (such those at HealthKeeperz) is crucial to making an informed decision regarding Medicare enrollment and plan changes.
Embracing Digital Solutions for a Burgeoning Online Health Care Community
The future of coverage for Medicare telehealth services may remain uncertain, but the efficacy and desirability of telehealth options were proven during the pandemic. Technological innovations in the field of telehealth have been both lifesaving and game changing. However, patients and their families are not the only ones for whom such advances created a welcome 21st-century safety net. Home health care service provider companies and the members of the caregiving community have reaped the rewards of a thriving digital universe as well.
Pandemic’s Impact on Remote Working
As more caregivers went remote during the pandemic, a new set of work-related problems arose. For the service providers who employed them, there were difficulties with scheduling and accurately tracking the hours worked and services provided. For the caregivers themselves, there was a feeling of disconnection and isolation that often compounded an already stressful job.
“Some of the largest difficulties in home-based care stem from one reality: that the workforce is remote,” wrote reporter Patrick Filbin in a Dec. 9, 2022, story for Home Health Care News. “Yet, providers often preach about the importance of cultivating a culture that is welcoming, engaging, and gives employees a sense of purpose.”
Innovative Solutions for Remote Working
Thankfully, the digital marketplace was quick in coming up with a number of innovative solutions, such as the Connecteam app, specifically designed to deal with the unique demands of a decentralized workforce. Not only does the app give remote workers a platform to connect with one another, Filbin reported it also allows them to “get real-time updates on their schedule, communicate easily with their managers, request time off, review their pay, and conduct other everyday tasks that were previously done manually or by several applications.” For service providers, the app creates “electronic visitation verifications” detailing site visits, hours worked, tasks provided, and supplies distributed during each home health interaction.
In addition to work-related apps, other invaluable coping tools for home care workers include online caregiving support communities. “A good caregiver support group can be a lifeline, providing a place … to share feelings confidentially, make friends, get help navigating the health care system, and learn from others who have walked a similar path,” wrote Marsha Mercer in an Aug. 31, 2021, piece for AARP.
There are support groups for specific caregiver concerns including Alzheimer’s/memory loss, hospice, caring for a spouse or parent, and others. “There are support groups of faith institutions, medical centers, disease associations, adult day care centers, social service agencies, and by businesses for their employees,” Mercer reported. Some faith-based home health providers, such as HealthKeeperz, offer ongoing, inclusive community ministry to staff members as well as patients and their families.
